Penile Fracture: New Research Provides Clues

In a new article from the Journal of Sexual Medicine, Dr. Andrew Kramer – a surgeon at the University of Maryland School of Medicine – writes about the relatively rare event of “penile fracture” (what some commonly call “breaking your penis”). But rather than reporting on his successful treating of these events (which many surgeons and urologists find themselves doing from time to time), he instead reviewed past patients to try to find out situations that make these fractures more likely to happen in the first place. And that’s where things get interesting.

As there are no bones inside of a man’s penis, it’s not a break or fracture in the way we typically think of it. Rather, a penile fracture represents a tear or, as Dr. Kramer says – “a disruption” – of the tunica albuginea, which I’ll call TA here for short. The TA essentially “houses” various tissues inside of the penis that are involved in swelling during sexual arousal and increased blood flow. So if the TA tears – or is “disrupted” in medical speak – then things get tricky very fast.

The tell-tale sign is that a man and his partner often hear a popping or cracking sound. His erection then decreases and bruising/bleeding underneath the skin is often noticeable. If this ever happens to you, you should definitely go to the emergency room right away. This is something you want to get treatment started on ASAP rather than wait it out.

So how do penile fractures happen in the first place? And, by extension, what can you do to prevent them from happening to you?

Past case reports of penile fracture have mainly focused on sexual position. Woman on top and rear entry (doggie style) have been described as common positions linked to penile fracture as they sometime involve the penis and vagina separating completely before joining again (in other words, LOTS of in and out – with the focus on completely “out” before going back in). This can happen in any sex position, but has been noted to happen particularly during positions like woman on top and rear entry. Missionary, for example, is a position in which people’s bodies tend to stay “joined” more often.

Interestingly, when Dr. Kramer reviewed the charts of the 16 patients who had been treated at the University of Maryland between 2007 and 2011 (most of whom he’d met/treated), he found two interesting features:

1) Half of the penile fractures occurred when a man was having an extramarital affair
2) The vast majority (all but 3) occurred when sex was happening somewhere other than a bedroom – for example, in a car, elevator, workplace, or public bathroom

Dr. Kramer concludes my suggesting that most of the penile fracture cases that they’ve seen in recent years tend to happen in aytpical and perhaps “stressful” situations. As a sex researcher, I can’t help but add that these are also perhaps “highly arousing” situations in which a man may be likely to have a stronger erection than usual (which makes it prime for “breaking” – soft penises can’t “snap”). Also, when people are highly aroused they sometimes make less-than-smart decisions. While having sex in an elevator may seem exciting, the logistics can make it challenging for most people to maneuver with pleasure, let alone maneuver safely.

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Dr. Debby Herbenick is a sex researcher at Indiana University, sexual health educator at The Kinsey Institute, columnist, and author of five books about sex and love. Learn more about her work at www.sexualhealth.indiana.edu.

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